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After an A.C.L. tear the knee becomes unstable, it buckles or gives way when you take a sudden turn or even a small jump. One feels insecure while walking onuneven ground and slopes and one experience a lot of apprehension during such activities. Over a period of time the knee might give way even during normal walking. After an A.C.L. injury your leg bone slides easily over the thigh bone. The abnormal movement causes progressive damage to other structures inside the knee, like meniscus and articular cartilage and eventually leads to early wearing off (arthritis) of the knee . There may a small tear or large bucket handle tear of meniscus or cruciate ligament rupture or simple synovitis, loose body, osteochondral fragment, synovial chondromatosis. Loose bodies can be removed arthroscopically. In synovial diseases punch biopsy is taken. Tear in the peripheral part of the meniscus can be repaired with suture but if injured in the central part where blood supply is less and union is difficult, we have to remove that by punches, grasper and shaver.